Phimosis hemostatic forceps



Dec. s, 193s.

s. U. slvoN Er AL PHIMOSIS HEMOSTTIG FORCEPS Original Filed March 15,1932 2 Sheets-Sheet 2 .Inventors manual 13.1936

PHIMOSIS HEMQSTATIC FOBCEPS Stephen Ulysses Sivori,l Ravenna, and Charles Arthur Sivan. Palnesvllle Ohio original No. amatissimo February 13, 1934, serai No. 59am, mmh 15.1932. Application for reissue November 23, 1935, Serial No. 51,310

30 Claims. (Cl. IHS) Our invention relates generally to instruments for performing minor surgery, and particularly to a forceps for performing the operation known' as circumcision.

'It is an important object of our invention to provide a relatively inexpensive. mechanically efficient, device of the character described which enables the performance of surgically correct operations. l

It is also an important object of our invention to provide an instrument of the character described which produces for the operation a hemostatic condition which remains after the performance of the operation of circumcision, so

15 that ties and bandages are not n subsequent to the operation.

It is also an important object of our invention to provide an instrument of the character described with which the operation of circumcision may be performed so as to produce, as a result of the operation, hemostatic surfaces upon the severed edge of the tissue.

Another object of our invention is to provide for the severing of the foreskin of the penis along n 25 line which is on a plane parallelto the plane running through the corona of the penis.

Another object is to provide for the severing of the foreskin without injury to the frenum or to the glans.

A still further object is to provide a device which will sever the foreskin on both sides of the penis in one operation.

Another object is the provision of an lnstrument which will firmly hold the entire foreskin 35 to be cut while the said foreskin is severed.

Stili another object is to provide an instrument for holding the foreskin which will permit the free circulation of blood in the glans during the operation on said foreskin.

It is also an important object of our inventio to provide an instrument of the type described for performing the operation of circumcision by the use of which the operation may be performed'v without requiring administration to the patient 45 of anesthetics, the operation being practically painless and capable of being ,very quickly performed.

Other obiects and advantages of our invention will be apparent from a reading of the following 50 description in connection with the drawings, wherein for purposes of illustration we have shown a preferred embodiment of our invention:

in which, r

Figure l is a general side elevational view of 55 the embodiment.

Figure 2 is a transverse vertical sectional view through Figure 1.

vFigure 3 is a vertical sectional view taken through Figure 1 at right angles to the view shown in Figure 2, yshowing the embodiment in closed position.

Figure 4 is a vertical transverse sectional view taken approximately on the line [-4 of Figure 3 looking in the direction of the arrows.

Figure 5 is a vertical transverse sectional view taken through Figure 3 approximately on the line 5 5 and looking in the direction of the arrows.

Figure 6 is a transverse sectional view through a tubular member.

.Figure 7 is an end view of the blade of the device.

Referring in detail to the drawings, the numeralA 5 generally designates the device of. our invention which is composed of the normally stationary lever i and the normally movable lever 1 which are crossed on a common pivot 8, As shown in Figure 2 the lever 6 is wider at the point where the levers cross and is provided with an opening- 9 Y in its side in which the lever 1 seats and works on the pivot l.

The lever 6 comprises the handle portion and the knife carrying portion II. The lever 1 comf prises the handle portion I2 and the knife accommodating portion I3.

'I'he portion I I ofthe normally stationary lever Y i has in its end a cylindrical opening Il which faces ,the portion I3 of the lever 6. Extending toward the pivot B from the opening I4 is a narrow slot I5 which is traversed by a pivot pin 'I6 and a retainer pin I1. Working in the slot I5 and extending from the slot toward the portion I 3 of the lever 1 is a knife operating lever IB which has an enlarged head portion I9 which the pivot I6 traverses eccentrically so as to endow the head I 9 with a cam action with respect to a knife structure which is axially movable in the opening I4 in the end of the lever in a manner to be described. A spring member 20 generally in the form of a numeral 6 having a suitable number of convolutions is arranged in the slot I5 about the pin I1 and engaged with the operating lever Il in such a way that the lever I8 is normally positioned outwardly in the inoperative position. It A will be observed that the handle portion of the lever I8 is oilset to one side of the levers 6, 1 to a position convenient for operating the same while holding the levers 6 and 1 closed. A

The cylindrical opening I4 in the end of the portion I I of the lever 6 is located in a knife bearf ing head 22 which has an angularly arranged inward end generally designated 23. so that when the levers are brought together into the closed position the surface Il engages theportion Il of the lever 'I at an angle.

Theendportionoftheportion Ilofthelever I is generally circular in iormv providing a head Il provided with a meeting face 2l at such an angle that when the meeting face Il of the head n meets the meeting face!! ofthe head 24. they will coincide and meet on all points.

Reference to Figure 4 shows that the meeting face 2i of the head Il of the lever 1 has thereon the annular portion Il which is rounded in contour and sloped slightly inwardly toward its center and leads into an annular knife receiving groove; 2l which is formed on an axis which colncides with the axis of the cylindrical opening i4 in the head 22 when the heads are registered. spaced concentrically inwardly from the groove 2l is a cylindrical passage Il through which the penis glans of the patient is extended when the levers are brought together for producing the hemostatic condition referred to herein and during the performance of the operation. The annular surface 2| is specially formed to cooperate.

with conformably convexed annular surface II on the mee face Il of the head 22 for producing the uniform hemostatic condition of the skin and tissues which are to be placed between the meeting surfaces at the outset of the operation of circumcision and which are to be crushed by the bringing together of the meeting faces whereby the required hemostatic condition is produced and localised.

The tubular guide generally designated Il whiehisshown insectioninliigureandinl'igureshasatubularportionsl havinganaxial opening I2 of the samesise asthe opening 2l in the head 24 on the lever 1, and its meeting endiscutoif'atanangieasindicatedatsl similar to the angle of the meeting face Il of the head Il. 'I'he cross section of the tubular portion ll is exsctlythesameasthatoftheannularportion lasdeilnedbytheopening Il andthegroove 21 in the head Il. so that when the heads Il; 2l are brought together the end of the tubular portion li of the. guide 8l and the portion 2l will register and engage at all points.

Outward of the tubular portion Il is a portion of larger diameter u which is exteriorly screwthreaded for threading into the outer end of the head Il, and outward oi' the portion Il is the portion of still larger diameter Il which may be suitably knurled as shown' in Figure i to eni able easily manipulating the same into and out of threaded engagement with the head Il. Y

Blidable in the annular chamber defined by the resulting space between the opening il in the A head 22` and the outside of the tubular. portion ll of the guide 3l, is the cylindrical knife gener- I ally designated Ilwhose working end has a pe` and disposed such that the plane ninningthroughsaidedgeisatananglesimilarto the angle at which the meeting face 2l is disposed, the other end being square cutfor seating against the shoulder denned by the tubular portion ll and the threaded portion of greater diameter I4 on the guide ll. Projecting from one side of the cylindrical blade '3l isa boss 81 which works in a slot provided in the side of the head 22 and which communicates with the slot Il in the portion ii oi' the lever l. A-portion of the enlarged head Il of the operating lever il removed from the pivotal center of the lever is formed with'a notch Il for receiving the boss Il in the manner soso:

showninll'igure. Itwlllbeobvlousthatwhen the'lever il ismovedin the direction of the arrows showninl'igureathatthecylindrical blade Il will be moved toward the right. In the position of the lever shown in Figure 3 the cutting end of the blade will then enter the annular groove I'I in the meeting face of the head 2l of the lever 1, and upon release of the lever Il the spring 2l will return the blade to initial position. The blade is shown in its initial position in Figure 3.

The axial opening 32 through the guide II in the stationary lever is registered with the opening 2l in the head 24 of the movable lever when the levers are closed. so that a continuous regular passage is provided for receiving the penis of the patient during the operation.

The operation is initiated by placing the preparedorgan through the opening n in the lever l, then arranging the prepared tissues and flesh properly upon the concave annular surface Il. Then lever 1 is swung so that its head 24 approaches the organ and receives the same through theopening Il, and the said tissues and nesh are then engaged on their other side by the convex annular surfacellof the lever '|,whereupon pressure is exerted upon the levers to crush and hold the More specific directions for utilising the device of the invention are as follows:-

Theforeskin of the organ is grasped with a hemostat and dilated, and then cut. longitudinall'y of the penis' and on the side opposite the frenum, with scissors to the point of circumcision. With the hemostat the foreskin and the organ are pulled through the opening 82 of the device of oin' invention. the levers being opened as far as possible. Then the foreskin is grasped with prei'- erably four hemostats equally spaced or divided. and the foreskin stretched so that the area of circumcision is placed accurately over the circular knife Il and the concave annular portion fl.

'lhen. the lever I is swung toward the lever l Then the hemostats are removed, the severed foreskin allowed to fall away. and the device of the invention removed from the penis of the patient.

' Though we have shown and described hereinv a preferred embodiment of our invention, it is to be denilitel'y understood that we d0 not desire to limit the application of the invention thereto. and any change or changes may be made in material and structure and arrangement of parts. within the spirit of the invention and the scope of the subioined claims.

We claim as our invention:

1. An instrument of the type described for holding and cutting the foreskin of a penis comprising. a pair of pivoted levers. cooperating heads on said levers adapted to be registered and further adapted to hold said foreskin placed between the said heads. said heads having open spaces for accommodating said penis, a knife mounted in cooperative relationship with one of said heads, the other of said heads having an opening for receiving a portion of said knife, and means for moving said knife lrelative to saidv opening to cut the said foreskin between the said heads.

2. An instrument of the type described comprising a pair of crossed levers, cooperating heads on said levers adapted to be registered, a knife on one of the heads, and a knife receiving opening provided in the other head, and penis receiving openings in said heads, saidknife being movable, and knife operating lever means for moving the knife for severing a penis foreskin interposed and held between said heads.

3. A 'surgical instrument of the type described comprising a pair of crossed levers, a cooperating head on one end of each of the levers adapted to be registered when the levers are closed. said heads being provided. with axially registered openings adapted to be registered when the heads are in cooperating relation, said openings being adapted to receive a penis when registered, portions on said heads for cooperation in holding portions of the foreskin of the penis for producing a localized hemostatic condition therein when the levers are forcibly closed, knife means on one of the heads for severing the foreskin, operating lever means for operating the knife carried by said lever head for operating the knife during the production of the hemostatic condi' tion.

4. A surgical instrument of the type described comprising ja pair of pivotally connected levers, cooperating heads'on the levers provided with penis receiving openings arranged to register when the levers are closed. a tubular knife on one of the heads and a knife receiving opening provided in the other head.

5. A surgical instrument of the type described4 comprising a pair of pivotally connected levers, cooperating heads on the levers provided with penis receiving openings arranged to register when the levers are closed, a tubular knife on one of the heads and a knife receiving opening provided in the other head. said tubular knife and the knife receiving opening surrounding the penis receiving openings in the heads.

'6. In a`surgical instrument including a pair of pivotally connected levers, cooperating headsv on the levers having penis receiving openings arranged to register when the levers are closed; penis foreskin hemostasis producing formations on the meeting portions-of the heads, and knife` means carried by one head and cooperable with the'remaining head for severing the foreskin of the penis when hemostasis thereof has bee accomplished.

'1. In a surgical instrument including alpair of pivotally connected levers, cooperating heads on the levers having penis receiving openings arranged to register when the levers are closed; penis foreskin hemostasis -producing formations on the meeting portiom of the heads. and knife means carried byone head and cooperable with the remaining head for severing the' foreskin of the penis when hemostasis thereof has been accomplished. said hilfe means being of tubular form and movable into an annular `opening provided on the remaining head.

8. A surgical instrument of the type described v comprising a pair of pivotally connected levers,

cooperating heads on the levers provided with penis receiving o arranged to register when the levers are closed. a tubular knife on provided in the other' head, said tubularxnife and the knife receiving opening surrounding the penis receiving openings in the heads, said tubular knife and said knife receiving openings being one of the heads and a knife receiving opening tions and the working end of the knife being dis- 1 posed at ad angle to the axis of the penis receiving openings to produce circular and angular amputation of thev penis foreskin.

10. A circumcising instrument comprising, in combination, engaging means having a penis receiving portion, a second engaging means having a penis receiving portion, means for cooperatively moving the engaging means relative to each other, the arrangement of the said engaging means being such that the penis may be inserted through the penis receiving portion of the nrst engaging means and such that the foreskin may be engaged. between the two engaging means while the forward end of the penis extends into the penis receiving portion of the second engagingmeans, and means slidably mounted on one of the engaging means for cutting the foreskin.

ll. A circumcising instrumentcomprising. in combination, engaging means having a penis receiving portion, a second engaging means having a penis receiving portion, lever means for cooperatively moving the engaging means relative to each other, the arrangement of thefsaid engag'ing means being such that the penis may be inserted through the penis receiving portion of the first engaging means and such that the foreskin may be engaged between the two engaging means to-produce a hemostatic condition while the forward end of the penis extends into the penis receiving portion of the second engaging means, and means slidably mounted on one of the engaging means for cutting the foreskin.

12. A surgical instrument for use in hemostatically severing the foreskin of .the penis, comprising, in combination, a member having 'a penis receiving opening and having a portion adapted to engage said foreskin, a member adapted to engage said foreskin, and means connecting said members for moving one of said members longitudinally of said penis toward the other said member for exerting an axially directedpressureuponsaidforeskimtherebycausingassaidfoi'eskinissevered.k

i3. A surgical instrument for use in hemostaticaliy severing the-foreskin of the penis. comprising, in combination, a first member having a portion adapted to receive the head of the penis.andalsohavingaportionadaptedtoen gage one side of the'foreskin of said penis. a 1s of the foreskin to be cut in said circumcision in a` AISIS hemostatic means for controlling the flow of blood in the foreskin, said hemostatic means adapted to substantiallyl encircle the said penis, and associated cutting means slidably mounted on the said hemostatic means for severing the foreskin.

l5. A device for circumcising the foreskin of the penis and for the control of the blood flow caused by the circumcision, comprising, in combination. hemostatic means' adapted to accommodate said penis and to clasp said foreskin for applying pressure upon the foreskin, said hemostatic means being adapted to apply said pressure upon all parts direction longitudinall of said penis. associated cutting means carried by said hemostatic means for severing the foreskin to which said pressure is applied, and means for operating said hemostatic means and said'cutting means.

l6. A'surgical instrument for hemostatically removing the foreskin of the penis, comprising, in combination, lever means for applying pressure uponail parts of the foreskin to be cut in said circumcision, said lever means being adapted to be moved longitudinally ofA said penis and to engage' said foreskin laterally of said penis, and cutting means carried by said lever means for severing said foreskin under said pressure from said penis, and means for operating said lever means and said cutting means.

17. A surgical instrument for hemostatically removing the foreskin of the penis, comprising, in combination, a pair of pivoted levers having portions adapted to be disposed in an arc about said penis and to apply pressure to said foreskin, one of said portions having an opening adapted to accommodate, and to receive part of, said penis, cutting means mounted on one of said levers, means for moving said cutting means intermediate said levers from one of said levers toward the other of said levers, said cutting means being adapted to cut the foreskin while under the pressure of the said portions of the levers.

18. A surgical instrument for hemostatically severing the foreskin of the penis, comprising, in combination, a pair ofpivotally connected levers, cooperating members mounted on said levers, one of said members having a penis receiving opening, cutting means mounted upon one of said members,

the other of said members having a recess adaptedl to register with said cutting means, and operating means for operating said cutting means. the combination of the members and the cutting means being such that the foreskin of the penis is clamped between said members and severed by said cutting means.

i9. Asurgical instrumentfor hemostatically severing the foreskin of the penis comprising, in combination, a pair of cooperating members for clamping said foreskin, one of said members having a portion adapted to embrace said penis, means for moving said members relative to each other so as to hemostatically clamp said foreskin, cutting m'eans carried by one of said members for severing said foreshn, and operating means for operating said cutting means. y

20. A' surgical instrument for severing the foreskin of the penis along a line which is on a plane substantially parallel to the plane passing through the coronal of the said penis comprising, in combination, a pair of coop.

erating members for clamping said foreskin, one of said members having a portion adapted to em `brace said penis, said portion adapted to be disposed axially of. said penis, foreskin engaging portions on said members, said engaging portions being disposed on a plane which is substantially parallel to said plane passing through the corona,

means for moving said members relative to each other so asto hemostatically clamp said foreskin, cutting means carried by one of said members for severing the said foreskin along said line, and

operating means for operating said cutting means.

. 2l. A surgical instrument for severing the foreskin of the penis comprising, in combination, a pair of members adapted to engage the said foreskin between the said members, one of said members having a portion adapted to embrace said penis, cuttingmeans carried by one of saidmembers and extending toward the other of said members, and operating means for moving said cutting means relative to said other member so as to sever the foreskin between saidy members.

22. A surgical instrumentforhemostaticailysevering the foreskin of the penis along aline which is substantially on a plane passing through the penis and disposed at an acute angle to the frenal cord ofsaid penis so that said foreskin is severed without injury to the said frenal cord comprising, in combination, a pair of cooperative members, each of said members having a portion adapted to accommodate said penis, one of said portions bein'g adapted to substantially embracesaid penis, said portions adapted to be disposed axially of said penis, a foreskin engaging portion on each of said members, said engaging portions being disposed substantially 'parallel to said plane, means for clamping said members together so as to hemo-` statically clamp the said foreskin between said members, cutting means carried by one of said members, and means for operating said cutting means so as to sever the said foreskin clamped between the said members.

23. A circumcising instrument forhemostatically severing the foreskin of the penis, said foreskin having an inner and an outer layer of skin. comprising, in combination, a pair of members having foreskin engaging surfaces, one of said surfaces being adapted to engage the inner layer of skin of said foreskin and the other of said surfaces being adapted to engage the outer layer of skin of said foreskin, one of said members having a portion for embracing said penis, said portion adapted to be disposed axially of the penis, the said surfaces of said members being disposed at an inclined angle to' said axially disposed portion, means for clamping said members together so as to cause hemostasis in the foreskin.' and cutting means carried by one of said members for severin g the said foreskin clamped between said mem- 24. A circumcising instrument for hemostatically severing the foreskin of the penis comprising, in

combination, a rst member having a cylindrical 1 opening for accommodating said second member the foreskin between the said members, cutting 1| means carried by one of said members for cutting said foreskin, and operating means for operating said cutting means. v l

P 25. A device for hemostatically severing the foreskin of the penis comprising, in combination, a pair of members having foreskin engaging surfaces disposed radially of said penis, means for moving said members so as to exert pressure axially of said penis upon the said foreskin causing hemostasis of the said foreskin, cutting means supported by one of said members for severing the said foreskin, and operating rmeans for operating said cutting means.

26.A In a penis foreskin circumcising device having a pair of clamping'members adapted to embrace said penis for clamping the foreskin inter- -posed between the said clamping members and having operating means, of a blade having a tubular portion adapted to be carried by one of said clamping members, a cutting edge portion adapted to extend toward the other of said clamping members and to sever the foreskin interposed between said clamping members, and an engaging portion adapted to engage said operating means.`

27. In a penis foreskin circumcising device.said device having a pair of clamping members for clamping said foreskin, one of the clamping members being adapted to embrace said penis, and having operating means, of a blade member having an arcuate body portion adapted to be siidably carried by one of said clamping members, a cutting edge'portion extending from said body portion and adapted to sever the foreskin interposed between said clamping members, and an engaging portion adapted to engage said operating means.

28. In a penis foreskin circumcising device, said i device having a pair of clamping members for sono;

-disposed in an-arc clamping said foreskin along a piane which is substantially parallel to a piane `passing through the corona of said penis, one of the clamping members being adapted to substantially embrace said penis, yand having operating blade member having an arcuate adapted Vto be carried by one of said clamping members and to be moved relative to said ciamp ing member, a cutting portion projecting from said body portion and adapted to extend from said body portion substantially parallel to said penis. the said cutting portion being arranged to sever the foreskin interposed between said clamping members along a line which lies on said first mentioned plane, and an engaging portion adapted to engage said operating means.

29. In a penis foreskin circumcising device, said means. of a vdevice having hemostatic means and cutting operating means. of a cutting member adapted to be carried by said hemostatic means, said cuttln member being adapted to be disposed substantially circumferentially of said penis, the said cutting member having a cutting portion adapted to sever the foreskin in said hemostatic means and having an engaging portion adapted to engage said operating means. y,

30. In a penis foreskin circumcising device, said devi having hemostatic means, of a cutting member adapted to be carried by said hemostatic means, said cutting member being adapted to be about said penis and being adapted to extend substantially axially of th'e said penis, the said cutting member being adapted to sever the foreskin of said penis.

amm ULrssas srvon. casarse sama srvorev body portionl 

